Reader Questions:
Get the Scoop on Billing Before Credentialing
Published on Sun Jul 11, 2010
Question: Our practice has a new physician coming on board to replace a retiring doctor. When can I start billing for his services? Does it matter when he gets credentialed with the insurance companies?Ohio SubscriberAnswer: When you can bill for a new physician's services does depend on when you're able to get him credentialed. You'll also need to know the differences between the payers you'll be reporting the services to.Medicare: For Medicare, you're allowed to bill 30 days retroactively. Note that you'll count back 30 days from the physician's application date, not the Medicare approval date. So the sooner you get the application in, the better. The date depends on how you're submitting the application as well. If you submit the application via the Provider Enrollment, Chain, and Ownership System (PECOS), you have 30 days from the day you submitted the enrollment application to the Medicare carrier. If you file [...]